Depression is not an inevitable outcome of disclosure avoidance: HIV stigma and mental health in a cohort of HIV-infected individuals from Southern India

Previous research has shown that HIV stigma in India can be characterized by a framework dividing manifestations into enacted (discrimination), vicarious (hearing stories of discrimination), felt normative (perceptions of stigma's prevalence), and internalized stigma (personal endorsement of stigma beliefs). We examined whether this framework could explain associations among stigma, efforts to avoid HIV serostatus disclosure, and depression symptoms in a cohort of 198 HIV-infected individuals from Southern India who were followed up for one year as part of a study of antiretroviral adherence. Prior studies had suggested that disclosure avoidance was a primary outcome of stigma and that impaired well-being was a primary outcome of disclosure avoidance. Analyses from our longitudinal research revealed that the pattern of associations among stigma, disclosure avoidance, and depression symptoms remained consistent over time. Enacted and vicarious stigmas were correlated with felt normative stigma beliefs. In turn, felt normative stigma was correlated with disclosure avoidance. And, enacted stigma, internalized stigma, and disclosure avoidance were all associated with depression symptoms. However, even though the overall framework held together, internalized stigma and depression symptoms dropped significantly over time while other components remained unchanged. These findings suggest that, although HIV stigma may limit disclosure, it does not invariably lead to psychological maladjustment. Amidst ongoing perceptions and experiences of stigma, HIV-positive individuals can achieve significant improvements in their acceptance of the disease and in mental well-being.     

Are driving simulators effective tools for evaluating novice drivers’ hazard anticipation,speed management,and attention maintenance skills?

Novice drivers (teen drivers with their solo license for 6 months or less) are at a greatly inflated risk of crashing. Post hoc analyses of police accident reports indicate that novice drivers fail to anticipate hazards, manage their speed, and maintain attention. These skills are much too broadly defined to be of much help in training. Recently, however, driving simulators have been used to identify those skills which differentiate the novice drivers from older, more experienced drivers in the areas of hazard anticipation and speed management. Below, we report an experiment on a driving simulator which compares novice and experienced drivers’ performance in the third area believed to contribute especially heavily to crashes among novice drivers: attention to the forward roadway. The results indicate that novice drivers are much more willing to glance for long periods of time inside the vehicle than are experienced drivers. Interestingly, the results also indicate that both novice and experienced drivers spend equal amounts of time glancing at tasks external to the vehicle and in the periphery. Moreover, just as a program has been designed to train the scanning skills that clearly differentiate novice from experienced drivers, one might hope that a training program could be designed to improve the attention maintenance skills of novice drivers. We report on the initial piloting of just such a training program. Finally, we address a question that has long been debated in the literature: Do the results from driving simulators generalize to the real world? We argue that in the case of hazard anticipation, speed management, and attention maintenance the answer is yes.     

Competence in Coping with Future-Related Stress in Adolescents from France,Italy, Great Britain,and Germany

The present study investigated how European adolescents cope with perceived future-related stress. Altogether 3,154 adolescents (mean age of 15 years) from four countries (n = 1,071 Italians, n = 1,433 Germans, n = 308 French, and n = 341 British) participated in the study. They completed the Problem Questionnaire, which assesses future-related stress, and the CASQ, which assesses how three coping styles (active coping, internal coping, and withdrawal) are used to deal with future-related stress. German and British adolescents showed low levels of stress, whereas French and Italian adolescents had high levels. All adolescents anticipated future-related problems but did not portray their futures negatively. In addition, they dealt with future-related stress actively and showed high levels of coping competence. Adolescents used active coping strategies most frequently, followed by thinking about possible solutions. Dysfunctional coping strategies (e.g., withdrawal) were used much less often. The effects of age, gender, and family variables on stress perception and coping style were negligible. Overall, our findings highlight the tenets of positive psychology by revealing that adolescents are concerned about their futures and that they show high agency in dealing with future-related problems. Further, the findings are relevant for positive youth development programs, especially those which endorse positive orientation to the future and coping competence.     

Beyond the Conflict: Religion in the Public Sphere and Deliberative Democracy

Traditionally, liberals have confined religion to the sphere of the ‘private’ or ‘non-political’. However, recent debates over the place of religious symbols in public spaces, state financing of faith schools, and tax relief for religious organisations suggest that this distinction is not particularly useful in easing the tension between liberal commitments to equality on the one hand, and freedom of religion on the other. This article deals with one aspect of this debate, which concerns whether members of religious communities should receive exemptions from regulations that place a distinctively heavy burden on them. Drawing on Habermas’ understanding of churches as ‘communities of interpretation’, we explore possible alternatives to both the ‘rule-and-exemption’ approach and the ‘neutralist’ approach. Our proposal rests on the idea of mutual learning between secular and religious perspectives. On this interpretation, what is required is (i) the generation and maintenance of public spaces in which there could be discussion and dialogue about particular cases, and (ii) evaluation of whether the basic conditions of moral discourse are present in these spaces. Thus deliberation becomes a touchstone for the building of a shared democratic ethos.     

Does inequity aversion depend on a frustration effect? A test with capuchin monkeys (Cebus apella)

Brosnan and de Waal (Nature 425:297–299, 2003) reported that if a witness monkey saw a model monkey receive a high-value food, the witness was more inclined to reject a previously acceptable, but low-value food. Later work demonstrated that this alleged inequity aversion might be due to frustration induced by switching subjects from their role as models receiving a high-value food to the role of witnesses receiving a low-value food. In the present study, pairs of female capuchins exchanged a token for either a high- or a low-value food without switching their model–witness roles. Witnesses could exchange a token for a low-value food after an adjacent model had exchanged a token for the same food (Equity Condition) or for a high-value food (Inequity Condition). Failure- and latency-to-exchange measures showed that witnesses were unaffected by the food type offered to models (no inequity aversion). Moreover, models were unaffected by their history of food type offered (no frustration). These results join earlier work suggesting that alleged inequity effects depend on frustration-induction procedures. Furthermore, inequity effects sometimes fail to emerge because frustration induction in nonhuman primates is labile. This study complied with protocols approved by the Italian Health Ministry and all procedures were performed in full accordance with the European law on humane care and use of laboratory animals.     

Social facilitation of eating novel food in tufted capuchin monkeys (Cebus apella): input provided by group members and responses affected in the observer

Learning about food palatability from watching what conspecifics eat might be one of the advantages of group living. A previous study investigated whether group members' presence or eating activity account for social facilitation of eating of foods never previously tasted. Capuchins encountered novel colored foods when (1) alone (Alone condition) or (2) with group members visible in the nearby cage (Group-present condition) or (3) with group members present and eating a familiar food that had not been colored (Group+food condition). Social facilitation of eating occurred when group members were eating, despite the difference in color between the familiar food eaten by them and the novel food presented to the experimental subject. To clarify what subjects learnt from group members when social facilitation occurred, we further analyze here the data from the previous study. The number of visual exposures to the colored novel food (as a group member) correlated with increased consumption of that novel food when encountered later (as experimental subject). In contrast, the number of times that an individual fed on the familiar food (as a group member) did not decrease its consumption of novel food (as experimental subject). Therefore, capuchins (1) habituated to the colors of the novel foods, and (2) did not take into account that seeing group members eating a food does not provide information about the palatability of a differently colored food. Since social facilitation of eating occurs when foods do not match in color, at least in capuchins, social facilitation of eating should not be considered as a way of learning about a safe diet, but rather as a way of overcoming neophobia. Accepted after revision: 18 August 2001 Electronic Publication     

Brief systemic work in psychiatric settings where a family member has been diagnosed as schizophrenic

In this paper I discuss work with the families of patients diagnosed as schizophrenic. The focus is on two particular aspects of such work: special features of therapy with these families and the important preparatory contextual work that needs to be done with colleagues in the professional network.